Pain, constant trips to the bathroom, and an inability to thoroughly enjoy food can make an irritable bowel disease almost unbearable. Many IBD patients find themselves in and out of hospitals with a bag full of new pharmaceuticals. Is there another option? If recent research means anything, it looks like there is an alternative. Here’s how cannabis can treat irritable bowel diseases.
What is inflammatory bowel disease?
In severe cases, inflammatory bowel disease (IBD) can be relentless. For some unknown reason, renegade inflammation takes over all or some part of the digestive tract. This causes a whole host of problems, many of which send patients running to the bathroom multiple times a day.
The most common forms of IBD affect the small intestine and the colon. There are a few conditions that fit under the IBD umbrella. The two most common are ulcerative colitis and Crohn’s disease. The severity of these conditions ranges greatly from patient to patient.
According to the Mayo Clinic, some major symptoms of both include:
- Abdominal pain and cramping
- Blood in stool
- Reduced appetite
- Unintended weight loss
Two additional disorders categorized as inflammatory bowel diseases are collagenous colitis and lymphocytic colitis. However, these two disorders are often distinguished from the more common and classic forms of IBD.
Cannabis and inflammatory bowel disease (IBD)
Over the past decade, cannabis has shown therapeutic promise in a wide variety of conditions. Some areas of research are more promising than others.
Fortunately for those who have an IBD, cannabis medicines seem to be living up to expectations. But, how what gives the herb so much potential? How does it affect the digestive tract?
Both cannabis and gastrointestinal medicine are hot topics in the science world. The research on cannabis and gastrointestinal health is emerging, but what has been discovered is fascinating and opens doors to new treatment approaches for those with insufferable bowel diseases.
Cannabis in the gut
Some may find this surprising, but the gut holds 80% of the human immune cells. The gut is also connected directly to the brain through the vagal nerve, an information highway that can tell you when you’re hungry, inform you that you are sick, and even trigger the fight or flight response.
So, where does cannabis fit in? Compounds in the herb (cannabinoids) directly engage with regional immune cells and the vagal nerve. Cannabis has immunomodulatory properties and also can impact messages sent between the gut and the brain.
Cannabis has these effects because cannabinoids tap into the endocannabinoid system (ECS) throughout the gastrointestinal tract. The ECS is a large network of signaling cell receptors that maintain optimum balance in the body. The majority of
The majority of cannabinoid receptors are located in the central nervous system. But, the gastrointestinal tract and immune system contain cannabinoid receptors as well.
The ECS can get quite complicated. For more information, please see our full article here.
How does cannabis help IBD?
Compounds in cannabis cause biochemical changes in the gut. In the case of IBD, these changes seem beneficial. If you are feeling nauseated, vaping a little cannabis blocks messages from the gut that tell the brain that you need to vomit.
This is one reason cannabis has such potent anti-nausea properties. Studies have shown that THC binds to a specific cell receptor (the CB1 receptor) on the vagal nerve, altering gut-brain communication. This is thought to reduce nausea and vomiting, as well as cause changes in pain perception.
In terms of the immune system, cannabis compounds like CBD and THC engage immune cells. Specifically, they have potent anti-inflammatory properties. They halt pro-inflammatory proteins and encourage anti-inflammatory proteins.
But, there’s a lot more to it than that. Here are three ways cannabis may treat IBD:
1. An inflammation-fighting herb
One 2008 review articulates that one type of cannabinoid receptor, the CB2 receptor, was not very common in a healthy intestinal tract. However, when the intestines became inflamed, more CB2 receptors popped up. The CB2 receptor is most abundant on immune cells. These receptors were calling out for endocannabinoids, the body’s natural THC.
The CB2 receptor is most abundant on immune cells. These receptors were calling out for endocannabinoids, the body’s natural THC.
In the case of IBD, the potent inflammation-fighting compounds in cannabis can drastically reduce symptoms caused by an excessive amount of intestinal inflammation. Both CBD and THC engage cannabinoid receptors, albeit in different ways.
In 2010, British researchers tested both THC and CBD in rodent models of colitis. They found both compounds not only reduced inflammation but they also “lowered the occurrence of functional disturbances”. That’s a nice way of saying that cannabis extracts reduced diarrhea.
The study also concluded that using both CBD and THC together could have additional benefits in the treatment of IBD.
2. Cannabis for abdominal pain
The endocannabinoid system also plays a role in pain sensation in the gut. In fact, activation of CB2 receptors blocks some pain perception and reduces hypersensitivity. One
One author suggests that the exaggerated presence of CB2 receptors in an inflamed gut calms down the nervous system. This disrupts signals from the gut to the brain that would otherwise tell you that you are in pain.
In IBD, pain can be severe. As mentioned above, compounds in cannabis activate cannabinoid receptors. This disrupts pain signaling. Combined with the herb’s potent anti-inflammatory properties, it seems like IBD patients may experience less pain, improved bowel functioning, and less excruciating and even life-threatening inflammation.
Clinical trials in humans are sorely needed, but the pre-clinical research is certainly promising.
3. Weight gain and health status
When you can’t properly digest your food, you run the risk of developing nutrient deficiencies and losing unnecessary weight. This is something cannabis may be able to help. The herb has a reputation for inspiring the munchies. Yet, with IBD, it may promote weight gain and improve overall health status as well.
This is something cannabis may be able to help. The herb has a reputation for inspiring the munchies. Yet, with IBD, it may promote weight gain and improve overall health status as well.
One 2012 study followed 13 IBD patients for three months of medical cannabis treatment. The long-standing IBD patients began to gain weight and improved their BMIs.
The patients also reported an improved quality of life, less disease activity (flare-ups), less depression, less pain, and improved social functioning and ability to work.
Not bad for a simple plant.
We’ve written a whole piece on the pros and cons for cannabis and digestion. Read it here.
Conditions helped by medical cannabis
In theory, there is quite a lot of pre-clinical evidence that cannabis can drastically improve disease symptoms and improve quality of life in those with IBD.
Unfortunately, the Schedule 1 status of cannabis makes the herb difficult to research in humans. But, there are a handful of small human studies worthy of mention.
Here is some recent research for the two most common irritable bowel diseases:
The participants were divided into two groups: a cannabis-receiving group and a control group. The those receiving cannabis treatment were given 115mg of THC.
The THC was smoked twice daily. The control group received cannabis with the THC extracted. The treatment lasted 8 weeks. Follow up was after 2 weeks.
11 of the participants were given cannabis. Of the 11, 5 achieved complete disease remission. 10 of the 11 showed a positive clinical response to the cannabis treatment.
Though this is a small study, the results are quite impressive. Almost half of the patients were able to achieve remission. Yet, the downfall of this trial is the use of smoked cannabis.
We’ve written an entire article on cannabis for Crohn’s Disease. Read it here.
Quality studies on cannabis for ulcerative colitis are few and far between. The majority of evidence focuses on Crohn’s or makes generalizations about irritable bowel disease.
However, a 2011 survey questioned 100 ulcerative colitis and 191 Crohn’s patients about medical cannabis.
Of the 100 colitis patients, 51% reported lifetime cannabis use. Of those lifetime consumers, 33% reported that they used the herb to alleviate disease symptoms. These symptoms included diarrhea, abdominal pain, and reduced appetite. Patients who had a history of abdominal surgery were more likely to turn to cannabis for relief.
Though human research is lacking, animal studies and pre-clinical research show positive signs. Both CBD and THC have effectively slowed motility, reduced inflammation, and improved symptoms in rodent models of the disease.
Cannabis therapy may even reduce the risk of colon cancer. Colon cancer risk increases sharply when the large intestine is under chronic stress and inflammation.
To learn more about cannabis and the gut, check out the full article here.
There is a lot we still need to learn about cannabis and the gut. As of right now, there is ample anecdotal evidence and a wealth of pre-clinical research advocating cannabis as a potential treatment for inflammatory bowel diseases.
Unfortunately, without serious reform for medical research, patients are left to make difficult decisions about cannabis themselves. Luckily, signs are positive thus far.
Related article: Cannabis & The Gut: Does Weed Heal Or Harm?